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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom?

The Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research (HOVON-SAKK) collaborative study group evaluated outcome of patients (pts) with acute myeloid leukemia (AML) in first remission (CR1) entered in 3 consecutive studies according to a donor versus no-donor comparison.

We evaluated our results and those of the previous MRC, BGMT, and EORTC studies in a meta-analysis, which revealed a significant benefit of 12% in overall survival (OS) by donor availability for all patients with AML in CR1 without a favorable cytogenetic profile.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

A 34-year-old woman, in remission from acute myeloid leukaemia, had a positive postnatal Kleihauer result.

Hereditary persistence of foetal haemoglobin was excluded as a Kleihauer test performed in a pregnancy prior to the development of leukaemia was negative.

In this case, the patient was confirmed to be in a true molecular remission from leukaemia and yet appeared to have a residual clonal population of HbF erythrocytes; the significance of this finding remains unclear.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

A pilot study was undertaken to assess the safety, activity, and immunogenicity of a polyvalent Wilms tumor gene 1 (WT1) peptide vaccine in patients with acute myeloid leukemia in complete remission but with molecular evidence of WT1 transcript.

With a mean follow-up of 30 plus or minus 8 months after diagnosis, median disease-free survival has not been reached.

Further studies are needed to establish the role of vaccination as viable postremission therapy for acute myeloid leukemia.

Children with HLA-identical sibling donors who achieved a complete remission received an allogeneic bone marrow transplant as consolidation.

Of the 418 children who achieved remission and went on to consolidation with and without CsA, the DFS was 40.6% and 33.9%, respectively (P = .24).

In this study, intensifying induction with high-dose DAT and the addition of CsA to consolidation chemotherapy did not prolong the durations of remission or improve overall survival for children with AML.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Spontaneous remission of acute myeloid leukemia (AML) in adults is a rare but well documented phenomenon.

This study reports on a 64-year-old male patient with acute myelogenous leukemia (AML-M4, according to the French-American-British classification) that was developed on a background of chronic myelomonocytic leukemia (CMML) and then underwent remission after treatment with the gonadotropin-releasing hormone agonist (GnRH agonist) triptorelin for presumed prostate cancer.

Remission persisted for at least 4 years before the patient was lost to follow-up.

To the author' knowledge, this is the first report of remission in an AML-M4 case associated with hormone manipulation.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Myeloid sarcoma presenting as an isolated nodule in a patient with acute myelogenous leukemia.

We report a case of an elderly female in remission from acute myelogenous leukemia that presented with a nonhealing enlarging asymptomatic nodule on her right thigh.

A wide excision of the nodule and histological examination revealed myeloid sarcoma without evidence or overlap of leukemia cutis, which had been suspected from nodules that had developed early in the course of the disease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We hypothesized that the transplantation of purified haploidentical NK cells may be a safe and effective form of consolidation therapy that will reduce the risk of relapse among children with acute myeloid leukemia (AML) who are not treated with HSCT.

In this pilot study, we assessed the safety, feasibility, and engraftment of NK cell infusions in 10 patients with AML in first remission.

RESULTS: The 10 patients had a median age of 2.5 years (range, 8 months to 21 years) and a median leukocyte count of 62 x 10<sup>9</sup>/L (range, 4 to 487) at diagnosis.

One patient had prolonged NK engraftment (189 days), but no non-hematological toxicity.

Grade 3-4 non-hematological toxicity was limited to one respiratory viral infection and one episode of febrile neutropenia.

With a median follow-up time of 637 days, all patients remain in remission.

CONCLUSIONS: Haploidentical NK cells can be safely administered to AML patients who are in remission.

We have recently opened a new trial to evaluate the efficacy of NK cell therapy in children in first remission of AML.

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(PMID = 27962581.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t(8;21): a retrospective study from the European Cooperative Group for Blood and Marrow Transplantation.

PURPOSE: Patients with acute myelocytic leukemia carrying inversion 16 (inv16) or t(8;21) have a better initial response to high-dose cytarabine than patients without these chromosomal abnormalities.

They presently do not undergo transplantation in first remission (CR1), but there is concern about late relapses.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

An 18-year-old man in remission from acute myelogenous leukemia 3 years after a bone marrow transplant presented with signs of pseudotumor cerebri, including headache, visual changes, and papilledema.

He was diagnosed with an isolated central nervous system relapse of acute myeloid leukemia.

Although the precise etiology remains elusive, this case demonstrates that pseudotumor cerebri must remain within the differential diagnosis after other complications are excluded, particularly in persons with underlying hematologic malignancies.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The aim of this study is to assess the frequency and clinical characteristics of cytosine arabinoside-induced fever in patients with acute myeloid leukemia in remission, receiving high-dose (3 g/m2) consolidation therapy.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Immunotherapy prospects for acute myeloid leukaemia.

While chemotherapy is successful at inducing remission of acute myeloid leukaemia (AML), the disease has a high probability of relapse.

Evidence for immunosurveillance of AML and susceptibility of leukaemia cells to both T cell and natural killer (NK) cell attack and justifies the application of immune strategies to control residual AML persisting after remission induction.

Here we describe what is known about the immunological features of AML at presentation and in remission, the current status of immunotherapy and strategies combining treatment approaches with a view to achieving leukaemia cure.

Our results suggest that continuous infusion intermediate-dose cytarabine, together with mitoxantrone and etoposide, may induce CR in a significant proportion of patients with refractory or early relapsed AML, although remission duration was short.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The role of multiparameter flow cytometry for disease monitoring in AML.

Monitoring of the minimal residual disease (MRD) load has become essential for the choice of post-induction strategies in patients with acute myeloid leukemia (AML).

On the other hand, for most AML patients, multiparameter flow cytometry (MFC) represents a good option for MRD monitoring.

In virtually all AML patients, leukemia-associated immunophenotypes (LAIPs) are detectable with MFC.

Numerous studies demonstrated the prognostic power of the MRD levels determined by MFC at post-induction as well as post-consolidation time points in adults and children considered to be in hematologic remission of AML.

Thus, MFC can significantly contribute to risk assessment of patients with AML during and after treatment and allows clinicians to consider alternative strategies (e.g. allogeneic hematopoietic stem cell transplantation) earlier.

Clinical studies need to focus on a standardization of these approaches to facilitate the translation of MFC-based MRD assessment into therapeutic decisions in patients with AML.

[Publication-country] Netherlands

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Concomitant hairy cell and acute myeloid leukemia.

Secondary malignancies in patients with hairy cell leukemia (HCL) are well described and treatment of HCL is discussed as their cause.

We describe a 58-yr-old patient who presented with both acute myeloid leukemia (AML) and HCL at the same time.

Treatment with cladribine, daunorubicin and cytosine arabinoside, followed by autologous stem cell transplantation, induced complete remission of AML and hematologic remission of HCL for 22 months, when he relapsed with AML.

This concomitant occurrence of AML and HCL is suggestive of a genetic predisposition rather then coincidence or relation to purine analoga.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

To investigate whether serum biomarkers can be used to indicate the responsiveness of acute myeloid leukemia to remission induction chemotherapy, we performed MALDI-TOF protein profile analysis of patient sera.

The resulting spectra revealed a protein (or peptide) peak at m/z 7764 that varied in intensity; its intensity was much higher in samples from patients in complete remission than in those from patients with resistant disease or in samples taken prior to treatment (at the time of diagnosis).

This study demonstrates that PF4 protein levels are a good indicator for the recovery of blood count in the complete remission of acute myeloid leukemia.

METHODS: A 34-year-old female patient with acute myeloid leukemia on remission admitted because of sudden hearing loss in her right ear for 10 days.

The patient presented in this report is the first reported case with a granulocytic sarcoma of the cerebellopontine angle who presented with acute sensorineural hearing loss.

Despite the rarity of such a case, we would like to emphasize that leukemia must be kept in mind as an etiologic factor in sensorineural hearing loss and suggest that complete blood count and temporal bone imaging be routinely obtained.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Based on available data, all adults with AML under age 60 years with matched siblings should be considered for allogeneic transplantation in first remission, except for those with favorable risk cytogenetics and possibly those whose disease has normal cytogenetics and is FLT3/ITD negative and NPM1 positive.

Patients with matched siblings not transplanted in first remission should be followed closely so that transplantation in early first relapse can be considered.

RIC allogeneic transplantation using either a matched family member or a MUD can be considered for patients age 60 years or greater with AML in second or subsequent remission, or AML in first remission with intermediate or high risk disease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We describe a patient who developed myelodysplastic syndrome over 2 years after achieving complete remission of acute myeloid leukemia (AML).

The patient was treated in July 1998 with anthracycline, etoposide, and behenoyl cytarabine chemotherapy for AML (French-American-British classification, M2; World Health Organization classification, AML with maturation) and achieved complete remission.

The pancytopenia progressed rapidly, and he died 2 months after the diagnosis of MDS.

Therapy-related MDS and AML (t-MDS/t-AML) developing after treatment for acute leukemia is unusual; the primary leukemia associated with most cases of t-MDS/t-AML is acute promyelocytic leukemia (APL).

This unusual case suggests that AML excluding APL should be considered a primary hematologic malignancy for t-MDS/t-AML.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Granulocytic sarcoma involving the uterus and right fallopian tube with negative endometrial biopsy.

Granulocytic sarcoma is an extramedullary tumor associated with acute myelogenous leukemia (AML) and it is rarely seen in the female genital tract.

We report an unusual case of granulocytic sarcoma of the uterus and fallopian tube in an AML patient who presented with vaginal bleeding and persistent abdominal pain.

Biopsy did not reveal the diagnosis.

Pathology showed atypical myeloid cells infiltrating the muscle bundles which was consistent with granulocytic sarcoma involving the uterus and right fallopian tube.

Immunohistochemistry confirmed the diagnosis.

The patient is in complete remission for AML and being followed-up for granulocytic sarcoma.

Granulocytic sarcoma of the uterus and fallopian tube is very rare, and in AML patients with abnormal uterine bleeding but negative endometrial biopsy it should still be considered in the differential diagnosis.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Improved outcome in young adults with de novo acute myeloid leukemia in first remission, undergoing an allogeneic bone marrow transplant.

We assessed the outcome of 170 patients with AML in first complete remission, aged 1-47 years (median 29), who had undergone an allogeneic BMT before or after 1990 (n=80 and n=90, respectively); all patients were prepared with cyclophosphamide and TBI; the median follow-up for surviving patients was 13 years.

Patients transplanted after 1990 were older, had a shorter interval diagnosis-BMT, had less FAB-M3 cases, received a higher dose of TBI, a higher marrow cell dose and combined (cyclosporine+methotrexate) GVHD prophylaxis.

In conclusion, the overall survival of first remission AML undergoing an allogeneic BMT has almost doubled in the past two decades, despite older age and fewer M3 cases.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: To detect the methylation and expression of glioma pathogenesis-related protein 1(GLIPR1) gene in the acute myeloid leukemia (AML) cell lines and bone marrow cells from AML patients, and to determine the relationship between promoter methylation and expression of GLIPR1.

RESULTS: The level of GLIPR1 mRNA in the AML cell lines was lower than that in the chronic myeloid leukemia (CML) and ALL cell lines, whereas the methylation level of GLIPR1 in the former was higher than that in the latter.

The level of GLIPR1 mRNA in the AML cell lines was significantly increased, but had no obvious changes in the CML and ALL cell lines after 5-aza-2dC treatment.

The mRNA level of GLIPR1 in the AML bone marrows (0.38+/-0.20)was obviously lower than that in the ALL bone marrows (0.76+/-0.18), CML bone marrows (0.80+/-0.14), and control bone marrows(0.85+/-0.12).

The level of GLIPR1 mRNA in the bone marrows with complete remission AML was obviously higher than that in the AML bone marrows before the treatment (0.78+/-0.13 vs. 0.36+/-0.20); but there was no obvious difference between the ALL bone marrows and the control bone marrows, and the CML bone marrows and the control bone marrows (both P>0.05).

The positive rate of GLIPR1 gene methylation in the AML bone marrows (81.5%) was obviously higher than that in the ALL bone marrows(37.5%), CML bone marrows (27.5%) and the control bone marrows(14.3%).

The positive rate of GLIPR1 gene in the bone marrows with complete remission AML was obviously lower than that in the bone marrows before the treatment (12.5% vs. 75.0%), but there was no obvious difference between the ALL bone marrows and between the control bone marrows,and the CML bone marrows and the control bone marrows (both P>0.05).

There was a negative correlation between the mRNA level and methylation status of GLIPR1 in the AML bone marrows.

CONCLUSION: GLIPR1 expression is downregulated or even lost by promoter methylation in AML, and the expression and methylation level of GLIPR1 gene may have some significance in evaluating the curative effect of AML patients.

We report on a 75-year-old female presenting with a Core-binding Factor (CBF) AML of M4eo subtype.

However, a biopsy demonstrated granulocytic sarcoma.

Since the patient had no comorbidities and had been in excellent performance status until the diagnosis of AML, induction chemotherapy was initiated, with subsequent normalization of bilirubin, CA 19-9, lipase and AP.

Complete hematologic remission of AML was attained and the pancreatic mass could not be detected anymore.

Following one consolidation treatment, the patient remained in excellent health until relapse occurred 7 months later and she succumbed to AML.

In conclusion, AML can rarely mimic the clinical picture of pancreatic cancer.

The initially good response of this CBF leukemia highlights the principal usefulness of aggressive induction chemotherapy also in older AML patients, if they are carefully selected not only according to biological risk factors such as cytogenetics, but also to "host factors" (good performance status, lack of comorbidities, etc.).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Combination chemotherapy may induce remission from acute myeloid leukemia (AML), but validated criteria for treatment of elderly are lacking.

The remission intention (RI) rate for elderly patients, as reported to the Swedish Leukemia Registry, was known to be different when comparing the six health care regions, but the consequences of different management are unknown.

The Leukemia Registry, containing 1672 AML patients diagnosed between 1997 and 2001, with 98% coverage and a median follow-up of 4 years, was completed with data from the compulsory cancer and population registries.

Among 506 treated and untreated patients aged 70-79 years with AML (non-APL), there was a direct correlation between the RI rate in each health region (range 36-76%) and the two-year overall survival, with no censored observations (6-21%) (chi-squared for trend=11.3, P<0.001; r2=0.86, P<0.02, nonparametric).

Differences could not be explained by demographics, and was found in both de novo and secondary leukemias.

Survival of 70-79-year-old AML patients is better in regions where more elderly patients are judged eligible for remission induction.

Complete cytogenetic and morphologic remission of AML was evident on follow-up marrow aspirate and biopsy specimens from all patients.

In two of the four study patients, the disease remains in complete remission and the patients have an excellent quality of life (Eastern Cooperative Oncology Group performance status 0; no medications) and no organ toxicity more than 2 years and more than 4 years, respectively, after their blood and bone marrow transplantations.

Thus, in adolescents and adults, 153Sm-EDTMP may provide a relatively simple and effective means for using irradiation to eliminate AML within the marrow.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Regimen containing perarubicin for the treatment of newly diagnosed young patients with acute myeloid leukemia.

BACKGROUND AND OBJECTIVE: Chemotherapy regimen containing anthracyclines has been used as the standard treatment for acute myeloid leukemia (AML).

This study was to compare the efficacy and toxicity of the chemotherapy regimen containing perarubicin (THP) with that containing mitoxantrone (MIT) for young patients with newly diagnosed AML.

METHODS: A total of 129 patients with newly diagnosed AML, aged 16 to 60 years olds, were assigned for induction chemotherapy containing one to two courses with standard-dose cytarabine (Ara-C) and an anthracycline antibiotic, THP or MIT.

When complete remission was achieved after induction therapy, the patients received two courses of consolidation therapy identical to the induction regimen.

Maintenance treatment continued for three years when patients were in continuous complete remission (CCR).

CONCLUSIONS: Regimen containing THP plus Ara-C can be used for young adults with newly diagnosed AML for remission induction, but it is not superior to the regimen with MIT.

Consolidation chemotherapy with THP or MIT is feasible for young adults with AML after CR.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We have experienced a number of cases of AML1/ETO+ acute myelogenous leukemia that showed remission based on bone marrow (BM) morphological criteria, but that revealed clonal abnormalities in most cells by fluorescence in situ hybridization (FISH).

Interestingly, most of these cases had AML with AML1/ETO rearrangement.

To clarify the possible mechanisms underlying this phenomenon, we investigated the expression levels of G-CSFR in AML cells with AML1/ETO rearrangement by flow cytometry and real-time polymerase chain reaction (PCR).

The number of AML1/ETO+ cells expressing G-CSFR at baseline was significantly higher than that of AML1/ETO- AML cells (2673 vs 522).

This study reveals that cases showing remission after treatment with G-CSF mostly had leukemia with AML1/ETO rearrangement.

We recommend that remission should be confirmed by FISH, because malignant clones can be differentiated and masked in morphological examination or chromosome test, especially for AML with AML1/ETO rearrangement.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Evaluation of complete disease remission in acute myeloid leukemia: a prospective study based on cytomorphology, interphase fluorescence in situ hybridization, and immunophenotyping during follow-up in patients with acute myeloid leukemia.

METHODS: The authors studied 216 patients with AML at the time of initial diagnosis and during follow-up and correlated cytomorphology, interphase fluorescence in situ hybridization (FISH), and flow cytometry results to evaluate response status.

RESULTS: Interphase FISH was found to be correlated significantly with the clinical course at the time of complete cytomorphologic remission and was more reliable than morphology for defining CR.

CONCLUSIONS: The current results indicated that interphase FISH may be used as a valid MRD parameter in patients with AML.

Multiparameter immunophenotyping for MRD also was correlated strongly with the clinical course, and the authors suggest integrating such immunophenotyping into the routine diagnostic panel at the time of diagnosis and during the clinical course in patients with AML.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Abnormal expression of transcription factors LYL1 and LMO2 and interaction between them in myeloid leukemia].

OBJECTIVE: To explore the expression of the transcription factors LMO2 and LYL1 and the interaction between these 2 factors in myeloid leukemia cells and to analyze the significance thereof in leukemogenesis.

RESULTS: The MNCs of 51.1% of the patients with acute myeloblastic leukemia (AML) without remission expressed higher levels of LMO2, the MNCs of 62.2% of the AML patients expressed higher levels of LYL1, and the MNCs of 31.1% of those expressed both.

The K562 cells transfected with pcDNA3-LMO2 showed higher mRNA and protein expression levels of both LMO2 and LYL1, and the K562 cells transfected with pcDNA3-LYL1 showed higher mRNA and protein expression levels of both LYL1 and LMO2 too, as indicated by RT-PCR and WB, which suggested that the expression of LMO2 and the expression of LYL1 stimulated each other in the myeloid leukemia cells.

CONCLUSION: The abnormal expression and protein interaction of LMO2 and LYL1 may play a role in the abnormal proliferation and differentiation of myeloid hematopoietic cells.

Three of these patients developed MDS prior to the onset of AML.

Of the 5 patients who underwent chemotherapy, 3 remained in remission with a survival time of 29, 59, and 109 months, and the remaining 2 died as a consequence of chemotherapy toxicity.

Among the 6 patients (38%) who developed transient myeloproliferative disorder, 2 were lost to follow-up, 2 died from DS-associated congenital heart abnormalities and 2 survived without any AML changes.

The remaining 1 patient (6%) who developed ALL was still in his first remission although this patient suffered profound chemotherapy complications during treatment.

CONCLUSIONS: This study found that AML is the most common hematologic neoplasm in Taiwanese children with DS, especially megakaryoblastic leukemia.

Long-term remission of AML in DS patients can be achieved with appropriate treatment.

This study examined the individual parameters for CR in 1250 adult patients with de novo AML treated according to three successive study protocols.

In conclusion, < or =5% blasts in the BM, recovery of neutrophils and platelets, and the absence of extramedullary disease constitute the cornerstones for the definition of a haematological CR in patients with AML.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

PURPOSE To conduct a pilot study to determine the safety, feasibility, and engraftment of haploidentical natural killer (NK) cell infusions after an immunosuppressive regimen in children with acute myeloid leukemia (AML).

PATIENTS AND METHODS Ten patients (0.7 to 21 years old) who had completed chemotherapy and were in first complete remission of AML were enrolled on the Pilot Study of Haploidentical Natural Killer Cell Transplantation for Acute Myeloid Leukemia (NKAML) study.

With a median follow-up time of 964 days (range, 569 to 1,162 days), all patients remain in remission.

We propose to further investigate the efficacy of KIR-mismatched NK cells in a phase II trial as consolidation therapy to decrease relapse without increasing mortality in children with AML.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: While complete remission in acute myeloid leukemia (AML) can be achieved after chemotherapy (CT), relapses occur for the majority of patients, underlying the need to eliminate residual disease.

Based on dendritic cell (DC) vaccination, the triggering of an immune response against residual leukemia cells after CT could maintain patients in remission.

The aim of our study was to assess, for vaccine preparation, generation of monocyte-derived DCs in AML patients after CT.

MATERIALS AND METHODS: We evaluated efficiency of the production, yields, maturation, and functional properties of DCs from 22 AML patients at different CT stages compared to those from 15 healthy donors.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: Patients older than 55 years of age with acute myelogenous leukemia (AML) are less likely to achieve complete remission and more likely to experience toxicity with conventional induction chemotherapy than younger patients.

Azacitidine administered in the outpatient setting is well tolerated and can induce complete hematological remission in patients with myelodysplastic syndromes (MDS).

At higher doses, azacitidine has activity in AML.

Patients with blast counts up to 29% were initially treated as MDS, but by WHO now meet criteria for AML.

CONCLUSIONS: Azacitidine administered in the outpatient setting can induce remission in AML.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Advances in understanding the biology and genetics of acute myelocytic leukemia.

Acute myelocytic leukemia (AML) is a malignant neoplasm of hematopoietic cells characterized by an abnormal proliferation of myeloid precursor cells, decreased rate of self-destruction and an arrest in cellular differentiation.

As the immature cells accumulate in the bone marrow, they replace the normal myelocytic cells, megakaryocytes, and erythrocytic cells.

The incidence of AML increases with age, peaking in the sixth decade of life.

In the United States, there are about 10,000 new cases of AML and 7,000 deaths in those with an AML diagnosis per year.

Current molecular studies of AML demonstrate that it is a heterogeneous disorder of the myeloid cell lineage.

This paper will discuss the most recent understanding and research of the cellular origin of AML and associated common genetic mutations that fuel the neoplastic process.

Also discussed are how these advances have impacted the classification, selection of therapy, and definition of complete remission in AML.

Promyelocytic leukemia will be discussed in detail as this AML subtype reveals how our understanding of the biology and genetics of the disease has led to targeted therapy that results in a cure in up to 80% of patients.